Entry Form Thrombi 2020

Name & Surname

T-shirt Size (S/M/L/XL)

Email

ID Number

Tel Number

Category (intermediate /open)

Medical Aid Name

Med. Aid No.

Next of Kin

Next of Kin No.

Entry Fee: R300

Please email/sms/WhatsApp completed entries, indemnities and proof of payment to info@kestelladventures.com / 0723515553

Banking Details : Capitec Bank

Account Name : Kestell Adventures

Account Number : 1489178455

Branch Code : 470010

Indemnity 

I, __________________________________________ do hereby vouch that I voluntarily take part in Thrombi 2020, including the downriver racing, river run and all associated activities. I vouch that I am in good health. I understand that a competition of this nature involves risks of various kinds associated with outdoor activities, including but not restricted to boating, rescue exercises, emergency response and recovery. I acknowledge that I place myself voluntarily under the leadership of the organizers and others who may be assigned to conduct the activities. I agree that, should I have a serious problem of any kind with any activity, I will voice my views; and that should I decide, I may withdraw from that activity at my own discretion after informing the organizers; and that should I do so, it may influence the evaluation made of me by the organizers. In all matters of dispute I shall have recourse to the organiser for a ruling, which shall be final. No person other than myself is responsible for my actions or omissions. I hold harmless, and waive any claims of whatsoever nature against the organisers of Thrombi 2020, its office-bearers, associates, instructors, agents, helpers or fellow event members, and hereby expressly state that I will not deem them responsible or liable for any inconvenience, loss, injury, illness, death or misadventure, to my person or property, of whatsoever nature and howsoever caused. I agree to the conditions of the Thrombi 2020 payment, registration and cancellation and I understand there is no refund in the event of my withdrawal. Footage and photographs can be used for publicity by the organisers.

Signed_____________________________                        Date__________________

Signature of Legal Guardian (if under 18 years of age) _____________________________

Name of Legal Guardian___________________________________________________